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Friday, July 11, 2014

Why haven't more states expanded Medicaid yet?

By California Healthlinewww.philly.com
Originally posted June 26, 2014

Two years after Roberts issued the majority opinion upholding the Affordable Care Act, the decision to expand Medicaid is far from settled. Despite predictions that all states will eventually embrace Medicaid expansion, a significant number continue to hold out.

At last count, 26 states and the District of Columbia intend to expand Medicaid, while four are actively considering it and 20 have no plans to expand the program at this time.

The Medicaid expansion was considered the sleeper issue in the legal case against the ACA that ultimately made its way up to the Supreme Court. Stakeholders were closely watching issues like the constitutionality of the individual mandate, not thinking Medicaid would be significant. And yet, in a surprise decision, the Supreme Court effectively took the teeth out of one of the law's major efforts to expand health insurance, by making it illegal to penalize states for not participating in the Medicaid expansion.